Psychological distress and mortality among US adults: prospective cohort study of 330 367 individuals

Distress, multimorbidity, and complex multimorbidity among Chinese and Korean American older adults

BACKGROUND

Studies suggest that distress is associated with various health conditions such as hypertension, asthma, diabetes, and coronary heart disease. However, only few studies focused on Asian Americans and little is known about the association with multiple comorbidity.

METHODS

We conducted a cross-sectional analysis among 400 Chinese and Korean American participants (aged 50-75 years) of the STOP CRC randomized controlled trial. Perceived distress was assessed using the distress thermometer scale (range 0-10). Disease diagnosis was self-reported by the participants. Multimorbidity (MM) was defined as having ≥2 chronic conditions. Complex multimorbidity (CMM) was defined as having ≥3 of the following body system disorders: circulation disorder, endocrine-metabolic disorder, cancer, anxiety or depression, breathing problem, and other health problems. We performed logistic regression for CMM and Poisson regression with robust error variance for MM to estimate associations with distress, adjusting for potential confounders.

RESULTS

The mean age was 58.4 years and mean distress score was 3.65. One-unit increase in distress score was associated with a 1.22-fold increase in the odds of having CMM (95% CI: 1.04-1.42). The magnitude of association slightly increased after additional adjustment for socioeconomic factors and health insurance status (OR: 1.29; 95% CI: 1.10-1.52). Higher distress score was positively associated with MM but the association was only marginally significant (PR: 1.04; 95% CI: 0.99-1.10), adjusting for socioeconomic factors and health insurance status.

CONCLUSION

Our data suggest that higher perceived distress may be associated with simultaneous dysfunction of multiple distinct body systems among Chinese and Korean American older adults.

Impact of psychological distress on mortality in Spain. The importance of early detection and treatment of mental disorders

BACKGROUND

Mental health problems account for 14% of mortality worldwide. The aim of this study was to evaluate the association between psychological distress and mortality in the Spanish adult population.

METHODS

Data came from a longitudinal study in population ≥15 years of age (n=21,005) who participated in the 2011-12 Spanish National Health Survey, which was linked to mortality records as of December 2020. Mental health was assessed with the GHQ-12, defining psychological distress as a dichotomous variable using a GHQ-12 score ≥3 as the cutoff point. Using Poisson regression, standardized mortality rate ratios (SRR) were estimated for all-cause, cardiovascular disease, and tumor-related mortality, adjusting for sociodemographic variables, lifestyles, and comorbidities.

RESULTS

The standardized overall mortality rate in individuals with and without psychological distress was 14.58 and 10.90 per 1000 person-years, respectively, estimating an SRR of 1.34 (95%CI: 1.19-1.50). The SRR for tumor-related mortality was 1.17 (95%CI: 0.90-1.53), and cardiovascular-related mortality was related to higher distress (GHQ-12 ≥ 4): SRR of 1.22 (95%CI: 0.98-1.51). Among psychological distressed individuals, the overall mortality SRR for those with a previous mental disorder diagnosis was 1.18 (95%CI: 0.91-1.53) versus 1.34 (95%CI: 1.18-1.54) for those without such diagnosis (p for interaction=0.067). Similarly, distressed participants taking prescription drugs for mental disorders had a lower mortality risk than those not taking them (p for interaction=0.016).

CONCLUSIONS

Individuals with psychological distress had a higher risk of overall-, cardiovascular disease- and tumor-related mortality. This association was higher among participants not previously diagnosed with a mental disorder and those not taking medication for mental issues.

Psychosocial distress and associated factors among adult cancer patients at oncology: a case of Ethiopia

Background

Psychosocial distress is a chronic burden for cancer survivors, which impacts both their quality of life and their oncologic prognosis. Although the national cancer prevention and control program in Ethiopia has made efforts in cancer prevention, control, and management by implementing the national cancer control plan 2016-2020, there was no enough evidence about psychosocial distress among adult cancer patients. So, it is critical to understand the magnitude of psychosocial distress and the factors that contribute to it.

Objective

The purpose of this study was to assess the prevalence of psychosocial distress and associated factors among adult cancer patients at oncology units in the Amhara regional state, Ethiopia. 2022.

Methods

A multicenter institution-based cross-sectional study was conducted among a sample of 605 adult cancer patients from 30 April to 22 June 2022. A systematic random sampling technique was employed to select the study units. In addition, data were collected through interviewers administered questionnaires by using the validated and pretested tools. Distress was assessed using the Questionnaire on Stress in Cancer Patients Revised 10. Both bivariable and multivariable logistic regression was used to describe the association between dependent and independent variables. Independent variable with p < 0.25 in the bivariable logistic regression analyses were entered into multivariable logistic regression model. Variables with p < 0.05 in the multivariable logistic regression analyses were considered as statistically significant associated factors of psychosocial distress.

Result

A total of 593 adult cancer patients took part in this study with mean age of 46.86 ± 14.5 years. The overall prevalence of psychosocial distress was 63.74%. Variables such as being female [AOR = 1.98, 95% confidence interval (CI): 1.24-3.17], patients who lives in rural areas (AOR = 2.3, 95% CI: 1.49-3.54), community-based health insurance utilization (AOR = 0.34, 95% CI: 0.23-0.51), patients on chemotherapy treatment (AOR = 2.72, 95% CI: 1.38-5.39), patients with comorbidity (AOR = 3.2, 95% CI: 1.67-6.10), and symptom burdens such as severe fatigue (AOR = 1.65, 95% CI:1.09-2.39) and severe nausea (AOR = 2.07, 95% CI: 1.43-3.00) were statistically associated with psychosocial distress.

Conclusion and recommendation

In general, the findings of this study showed a relatively high magnitude in which around two-thirds of patients experienced psychosocial distress. It is better to establish and enforce the integration and coordination of psychosocial oncology service programs at national level with parallel guidelines and policies.

Association between psychological distress and disability-free life expectancy in the older Japanese adults

BACKGROUND

Our study aimed to investigate the association between psychological distress and disability-free life expectancy (DFLE).

METHODS

In 2006, a cohort study was conducted of 12,365 Japanese individuals aged ≥65 years, who were followed-up for 13 years. Psychological distress was measured using the Kessler 6-item psychological distress scale and was categorized into no (0-4), mild (5-9), moderate (10-12), and serious distress (13-24). The number of participants was 1277 (22.4 %) for mild distress, 330 (5.8 %) for moderate, and 208 (3.6 %) for serious in men, and was 1635 (24.6 %), 467 (7.0 %), and 384 (5.8 %) in women. Sex-specific DFLE was defined as the mean years a person could expect to live without disability and calculated by Interpolated Markov Chain (IMaCh) software.

RESULTS

Compared to no distress, DFLE loss per person was 1.21, 2.61, and 4.43 years for mild, moderate, and serious distress respectively in men. At population level, DFEL loss (i.e., DFLE loss per person×number of participants) was 1545.17, 861.30, and 921.44 years for mild, moderate, and serious distress respectively in men. Accordingly, 46.4 % of the total DFLE loss was attributable to mild distress, 25.9 % to moderate, and 27.7 % to serious in men. Similarly, the results were 42.2 %, 25.4 %, and 32.4 % in women.

LIMITATIONS

Psychological distress was measured only once at baseline, and 2409 participants were excluded from the analysis because of missing data on exposure.

CONCLUSIONS

At population level, almost half of the total DFLE loss could be attributable to mild distress, underscoring the importance of population strategy for all levels of distress in promoting healthy aging.

Identification and Characterization of Elevated Expression of Transferrin and Its Receptor TfR1 in Mouse Models of Depression

Depression has become one of the severe mental disorders threatening global human health. In this study, we first used the proteomics approach to obtain the differentially expressed proteins in the liver between naive control and chronic social defeat stress (CSDS) induced depressed mice. We have identified the upregulation of iron binding protein transferrin (TF) in the liver, the peripheral blood, and the brain in CSDS-exposed mice. Furthermore, bioinformatics analysis of the Gene Expression Omnibus (GEO) database from various mouse models of depression revealed the significantly upregulated transcripts of TF and its receptor TfR1 in multiple brain regions in depressed mice. We also used the recombinant TF administration via the tail vein to detect its permeability through the blood-brain barrier (BBB). We demonstrated the permeability of peripheral TF into the brain through the BBB. Together, these results identified the elevated expression of TF and its receptor TfR1 in both peripheral liver and the central brain in CSDS-induced depressed mice, and peripheral administration of TF can be transported into the brain through the BBB. Therefore, our data provide a compelling information for understanding the potential role and mechanisms of the cross-talk between the liver and the brain in stress-induced depression.

Financial Toxicity and psychological distress in Adults with Cancer: A Treatment-based Analysis

Objective

To evaluate disparities in financial toxicity and psychological distress in patients with cancer as a function of treatment and reveal the relationship between financial toxicity and psychological distress.

Methods

This was a multicenter cross-sectional study. Patients were recruited from March 2017 to October 2018, and questionnaires were completed regarding their demographics, financial toxicity, and psychological distress. A multiple linear regression model was used to examine factors associated with financial and psychological distress.

Results

Significant financial toxicity and psychological distress occurred in 47.9% and 56.5% of patients, respectively. Financial toxicity (P ​= ​0.032) and psychological distress (P ​< ​0.001) were statistically different among the single chemotherapy, adjuvant therapy, and surgery groups. Multivariable analysis revealed that patients aged 50–59 years (P ​= ​0.035), 60–69 years (P ​= ​0.007), and 70 years or older (P ​= ​0.002) had higher the Comprehensive Score for financial Toxicity (COST) scores compared with patients less than 50 years old. Patients with personal annual income > 40,000 CNY reported higher COST scores than those who had < 20,000 CNY (P ​< ​0.001). Patients who had Urban Resident Basic Medical Insurance (URBMI) (P ​= ​0.030) or New Rural Cooperative Medical Scheme (NRCMS) (P ​= ​0.006) compared with Urban Employee Basic Medical Insurance (UEBMI) presented lower COST scores than patients with UEBMI. The multiple analysis model of psychological distress showed that an age of more than 70 years (P ​= ​0.010) was significantly associated with low the Distress Thermometer (DT) scores, and patients with colorectal cancer (P ​= ​0.009), the surgery group (P ​< ​0.001) and adjuvant therapy group (P ​< ​0.001) were significantly associated with high DT scores. The correlations between financial toxicity and psychological distress were mild but statistically significant in the chemotherapy-related treatment groups.

Conclusions

The research highlights the high rates of financial and psychological distress in adult patients. Multidimensional distress screening and psychosocial interventions should be provided for patients with cancer according to related factors.

The relationship between activities of daily living and psychological distress among Chinese older adults: A serial multiple mediation model

BACKGROUND

Few studies have shed light on the mechanisms underlying the link between activities of daily living (ADL) and psychological distress. This study aimed to explore the multiple mediating roles of loneliness and sleep quality in this relationship among Chinese older adults.

METHODS

A total of 3250 older adults completed the Barthel Index, UCLA 20-item Loneliness Scale, Pittsburgh Sleep Quality Index, and Depression, Anxiety, and Stress Scale Questionnaire. Serial multiple mediation analysis was conducted using Hayes' PROCESS macro.

RESULTS

ADL was found to directly impact psychological distress through three significant mediation pathways: (1) loneliness (B=-0.124, 95% CI=-0.140, -0.109), which accounted for 23.98% of the total effect, (2) sleep quality (B=-0.050, 95% CI=-0.063, -0.039), which accounted for 9.67% of the total effect, and (3) loneliness and sleep quality (B=-0.015, 95% CI=-0.020, -0.012), accounting for 2.91% of the total effect. The total mediating effect was 36.56%.

LIMITATIONS

The cross-sectional design we used limited causal interpretations. Future studies could examine longitudinal changes in outcome measures.

CONCLUSIONS

These findings highlight the role of loneliness and sleep quality as serial mediators of the relationship between ADL and psychological distress. Thus, for the early detection and prevention of psychological distress, it is necessary to conduct loneliness and sleep quality interventions for older adults with ADL limitations.

Psychological stress, body shape and cardiovascular events: Results from the Whitehall II study

Background and aim

It is known that persistent psychological stress predicts changes in body shape in two different ways: some stressed people lose weight, others gain weight. It is also known that persistent psychological stress predicts adverse health events. But it is unknown what role the body shape plays in this particular network of relationships. We therefore analyzed the Whitehall II dataset to relate body shape to stress and health risk.

Methods

Data of 4969 men and 2138 women from the Whitehall II cohort were analyzed. Psychological stress (General Health Questionnaire) was measured three times in the years 1991 till 2001. Body shape (BMI, waist and hip circumferences) was measured in the years 1991 till 1994. Childhood adversities were retrospectively assessed by questionnaire. Outcomes included the incidence of non-fatal or fatal CHD events (coronary heart disease) collected up to the years 2012 and 2013 and all-cause mortality collected up to July 2015. Cox proportional hazard models were conducted to estimate the relation between psychological stress and CHD events or all-cause mortality.

Results

There was an increase in the expected hazard to develop CHD with high psychological stress (men: Exp (B) = 1.25 (1.06–1.47); P = 0.008; women: Exp (B) = 1.34 (1.05–1.70); P = 0.017). We found a clear dose-response relationship for the association between psychological stress and CHD events in both genders. That is, subjects with consistently high psychological stress in all assessments had a 2.4-fold (men) or 2.3-fold (women) higher risk for later CHD events compared to never-stressed subjects. Moreover, subjects with a high sum score of all 13 childhood experiences had a 10% increased hazard to develop fatal or non-fatal CHD events in adulthood. Although we could not find stress or BMI linked to all-cause mortality, the waist-to-hip ratio contributed to the risk of all-cause mortality in both genders (Exp (B) = 34.66 (6.43–186.92); P < 0.001 for men; Exp (B) = 60.65 (9.33–394.22); P < 0.001 for women).

Conclusion

This analysis supports the notion that psychological stress and childhood adversities are associated with the risk of fatal or non-fatal CHD events. When this relationship is analyzed in more detail, the Whitehall II dataset provides further insights into the role of body shape. That is, stress is also related to changes in body shape, with waist size in particular predicting higher all-cause mortality.

•

We used Whitehall II data and constructed an overall picture of the relations between psychological stress, body shape and adverse health outcomes.

•

We demonstrated a dose-dependent relationship between psychological stress and the risk of fatal or non-fatal CHD events.

•

Stress increases the risk of both CHD events and body shape changes, with waist circumference but not BMI increasing the mortality risk.

•

Body shape –more specifically waist size– is symptomatic of stress and predictive of all-cause mortality.

Social Epidemiology: Past, Present, and Future

In a context where epidemiologic research has been heavily influenced by a biomedical and individualistic approach, the naming of “social epidemiology” allowed explicit emphasis on the social production of disease as a powerful explanatory paradigm and as critically important for interventions to improve population health. This review briefly highlights key substantive areas of focus in social epidemiology over the past 30 years, reflects on major advances and insights, and identifies challenges and possible future directions. Future opportunities for social epidemiology include grounding research in theoretically based and systemic conceptual models of the fundamental social drivers of health; implementing a scientifically rigorous yet realistic approach to drawing conclusions about social causes; using complementary methods to generate valid explanations and identify effective actions; leveraging the power of harmonization, replication, and big data; extending interdisciplinarity and diversity; advancing emerging critical approaches to understanding the health impacts of systemic racism and its policy implications; going global; and embracing a broad approach to generating socially useful research.

Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

The Child and Adolescent Thriving Index 1.0: Developing a Measure of the Outcome Indicators of Well-Being for Population Health Assessment

The well-being of children and adolescents is emerging as an area of interest for population health measurement. Previous approaches assessing national and state trends in well-being have relied on composite indices. However, these methodologies suffer from several weaknesses. This paper develops an improved index for the United States that is measurable with existing population-data resources. It derives the appropriate weights for items in this index using a longitudinal panel of 2,942 children in the Panel Study of Income Dynamics. Candidate component measures are selected for the index based on their demonstrated association with several subjective scales assessed during young adulthood. The final index demonstrates that a broad range of measures indicate higher levels of population-level well-being. The predictive validity of the index for outcomes during young adulthood is also assessed: a one-standard-deviation increase in the index score is associated with a 7.9-percentage-point decrease [95% CI: 5.9 - 9.8] in ever reporting fair or poor health, a 6.3-percentage-point decrease [95% CI: 4.6 - 8.0] in ever reporting depression, and a 17.2% [95% CI: 13.7% - 20.5%] increase in peak earnings. These values for predictive validity are slightly higher than those of existing methodologies. We also find that incorporating contextual indicators from childhood and adolescence does not substantively improve predictive validity. Policy-makers and government agencies interested in population-level well-being of children and adolescents can continue to use existing indices as reasonable proxies, but should also commit to upgrading data systems to make them more child-centric in the future.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12187-022-09962-0.

Psychological distress as a risk factor for all-cause, chronic disease- and suicide-specific mortality: a prospective analysis using data from the National Health Interview Survey

PURPOSE

The risk psychological distress (PD) confers on mortality due to specific chronic diseases compared to suicide is unclear. Using the National Health Interview Survey (NHIS), we investigated the association between PD levels and risk of all-cause and chronic disease-specific mortality and compared the contribution of chronic disease-related mortality to that of suicide.

METHODS

Data from 195, 531 adults, who participated in the NHIS between 1997 and 2004, were linked to the National Death Index records through to 2006. Multivariable Cox regression models were used to estimate hazard ratios (HRs) and their 95% confidence intervals (CIs) across four levels of PD, measured using the Kessler-6 scale. Outcomes included all-cause mortality, and mortality due to all CVDs and subtypes, all cancers and subtypes, diabetes mellitus, alcoholic liver disease and suicide.

RESULTS

During a mean follow-up time of 5.9 years, 7665 deaths occurred. We found a dose-response association between levels of PD and all-cause mortality, with the adjusted HRs (95% CI) elevated for all levels of PD, when compared to asymptomatic levels: subclinical 1.10 (1.03-1.16), symptomatic 1.36 (1.26-1.46) and highly symptomatic 1.57 (1.37-1.81). A similar association was found for all CVDs and certain CVD subtypes, but not for cancers, cerebrovascular diseases diabetes mellitus. Excess mortality attributable to suicide and alcoholic liver disease was evident among those with levels of PD only.

CONCLUSION

PD symptoms, of all levels, were associated with an increased risk of all-cause and CVD-specific mortality while higher PD only was associated with suicide. These findings emphasise the need for lifestyle interventions targeted towards improving physical health disparities among those with PD.

Mental Distress during the Coronavirus Pandemic in Israel: Who Are the Most Vulnerable?

Based on Pearlin's stress process model and the social inequality approach to health, this study used a social lens to explore the role of socioeconomic inequities in mental distress during the COVID-19 pandemic in Israel. Specifically, we examined people's pre-pandemic sociodemographic characteristics and economic situation, and the economic effects of the pandemic itself on mental distress. A real-time survey was conducted in May 2020 among 273 adults (ages 20-68), and hierarchical linear models were employed. Findings indicated that groups vulnerable to mental distress in routine times (e.g., women, people with economic difficulties) showed the same pattern during the pandemic. Not only was unemployment related to mental distress, so too was a reduction in work hours. The pandemic's economic effects (e.g., needing to take out loans, having a worsening financial situation) were also associated with increased mental distress. This study is one of very few studies to explore a wide range of socioeconomic factors and their association with mental distress during the current crisis. The findings call for broader interventions to alleviate the economic distress caused by the pandemic to promote mental health, especially for groups that were vulnerable before the crisis and those most affected economically following the pandemic.

Chronic Conditions, Persistent Pain, and Psychological Distress Among the Rural Older Adults: A Path Analysis in Shandong, China

Psychological distress were found to be associated with chronic conditions and persistent pain. However, few studies explored the underlying pathways between them. This study aimed to analyze the path of chronic conditions and persistent pain on psychological distress through sleep quality and self-rated health. A total of 2,748 rural older people in Shandong, China were included in this study. Path analysis was performed by using Mplus 8.3 to examine the associations between chronic conditions, persistent pain, sleep quality, self-rated health, and psychological distress after adjusting for age, gender, education, and household income. The prevalence of psychological distress among the older adults in this study was 47.49%. Chronic conditions and persistent pain were indirectly associated with psychological distress through six mediating pathways: (1) the path from chronic conditions to psychological distress through sleep quality (β = 0.041, 95%CI: 0.015-0.067) and self-rated health (β = 0.064, 95%CI: 0.038-0.091), respectively, and a chain mediation existed (β = 0.007, 95% CI: 0.000-0.014); (2) the path of persistent pain and psychological distress through sleep quality (β = 0.058, 95% CI: 0.014-0.102) and self-rated health (β = 0.048, 95% CI: 0.000-0.096), respectively, also the chain mediation found (β = 0.009, 95% CI: 0.005-0.014). Psychological distress was associated with chronic conditions and persistent pain through decreased sleep quality and self-rated health among Chinese rural older people. Multi-pronged targeted intervention should be taken for older adults with chronic conditions and persistent pain.

Liver proteome alterations in psychologically distressed rats and a nootropic drug

Background

Chronic psychological distress is considered today a pandemic due to the modern lifestyle and has been associated with various neurodegenerative, autoimmune, or systemic inflammation-related diseases. Stress is closely related to liver disease exacerbation through the high activity of the endocrine and autonomic nervous systems, and the connection between the development of these pathologies and the physiological effects induced by oxidative stress is not yet completely understood. The use of nootropics, as the cognitive enhancer and antioxidant piracetam, is attractive to repair the oxidative damage. A proteomic approach provides the possibility to obtain an in-depth comprehension of the affected cellular processes and the possible consequences for the body. Therefore, we considered to describe the effect of distress and piracetam on the liver proteome.

Methods

We used a murine model of psychological stress by predatory odor as a distress paradigm. Female Sprague-Dawley rats were distributed into four experimental groups (n = 6 − 7/group) and were exposed or not to the stressor for five days and treated or not with piracetam (600 mg/kg) for six days. We evaluated the liver proteome by one-dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis (1D-SDS-PAGE) followed by liquid chromatography-tandem mass spectrometry (GeLC-MS/MS). Besides, we analyzed the activity of liver antioxidant enzymes, the biochemical parameters in plasma and rat behavior.

Results

Our results showed that distress altered a wide range of proteins involved in amino acids metabolism, glucose, and fatty acid mobilization and degradation on the way to produce energy, protein folding, trafficking and degradation, redox metabolism, and its implications in the development of the non-alcoholic fatty liver disease (NAFLD). Piracetam reverted the changes in metabolism caused by distress exposure, and, under physiological conditions, it increased catabolism rate directed towards energy production. These results confirm the possible relationship between chronic psychological stress and the progression of NAFLD, as well as we newly evidenced the controversial beneficial effects of piracetam. Finally, we propose new distress biomarkers in the liver as the protein DJ-1 (PARK7), glutathione peroxidase 1 (GPX), peroxiredoxin-5 (PRDX5), glutaredoxin 5 (GLRX5), and thioredoxin reductase 1 (TXNDR1), and in plasma as biochemical parameters related to kidney function such as urea and blood urea nitrogen (BUN) levels.

Role of routine check-up in the prognosis of patients with pancreatic cancer: A puzzling phenomenon

BACKGROUND

The high coverage of annual routine health check-up in China is a unique phenomenon throughout the world. However, its clinical value is controversial. In this cohort study, we chose pancreatic cancer as a disease model to explore the role of routine check-up in the prognosis of patients with pancreatic cancer.

METHODS

Data from 157 patients who were diagnosed with pancreatic cancer between January 2010 and April 2014 were collected. Patients were divided into two groups depending on how their disease was detected. Group A (n = 85): Patients were diagnosed with pancreatic cancer in clinic visits. Group B (n = 72): Patients were diagnosed with pancreatic cancer in routine check-ups. We compared their prognosis.

RESULTS

The tumor stage in group B was earlier than that in group A. The 1-year survival rate in group B was significantly higher than that in group A (74.6% vs. 42.4%, P < 0.001), while the 3- and 5-year survival rates of the two groups showed no significant difference (P > 0.05). The difference of overall survival time between the two groups was not significant (22.0 vs. 9.0 months, P = 0.078).

CONCLUSIONS

The stage of pancreatic cancer diagnosed in routine check-ups was earlier and therefore, the intervention was earlier which improved short-term survival rate. However, early intervention did not improve overall survival in the long-term.

Adherence to aerobic and muscle-strengthening exercise guidelines and associations with psychological distress: A cross-sectional study of 14,050 English adults

Physical activity (PA) is beneficial for the prevention and management of psychological distress. However, no studies have investigated which combination/s of PA prescribed in the current global guidelines (i.e. aerobic moderate-to-vigorous PA [MVPA] and muscle-strengthening exercise [MSE]) are most strongly linked to reduced psychological distress. This study aimed to examine how PA guidelines adherence is associated with psychological distress. Using cross-sectional data of adults (n = 14,050) who participated in the 2012-2016 Health Survey for England, four categories of self-reported PA guidelines adherence were created: meeting none, only MSE, only aerobic MVPA, meeting both (exposure variables). Psychological distress (outcome) was measured using the General Health Questionnaire-12. The likelihood of experiencing high levels of psychological distress (cut-point of ≥4) across guidelines adherence categories was examined using logistic regression models adjusted for sociodemographic and lifestyle factors. About 17% of adults experienced high levels of psychological distress; 37.5% did not adhere to any PA guidelines (category 1), 1.3% met only MSE (category 2), 35.5% met only aerobic MVPA (category 3), and 25.7% met both guidelines (category 4). Compared to category 1, the likelihood of experiencing high psychological distress was lowest in category 4 (OR = 0.65, 95% CI: 0.54-0.77) followed by category 3 (OR = 0.78, 95% CI: 0.67-0.90), while it did not differ in category 2 (OR = 1.24, 95% CI: 0.75-2.05). This is the first study to identify the association between PA guidelines adherence and psychological distress in a large population sample. Findings suggest that meeting both aerobic MVPA and MSE guidelines might be most beneficial for mental health.